For years — even before the Supreme Court overturned Roe v. Wade and that abortion clinics are closing across the country — Democratic state lawmakers have tried to regulate crisis-ridden pregnancy centers.
They have largely failed.
A series of court rulings and law enforcement rulings effectively overruled state laws that had sought to tackle so-called CPCs, which reproductive health rights groups say have spread misinformation and misrepresented to vulnerable women seeking resources, including abortion care.
But the blue states remain committed to reining in the contentious hubs, which people have come to rely on even more since Roe’s fall, and they are trying to do so with a much more targeted approach.
Reproductive rights advocates praise some of these innovative and nuanced strategies, while continuing to lament the broader landscape that has largely prevented them from curbing what they say are pervasive deceptive practices.
“Legislators want to find solutions that do not violate the rights of the CPC, but protect the rights of patients. It’s really, really difficult, so you see different places doing it differently,” said Callie Wells, policy adviser at Planned Parenthood.
“But it’s been a long time since a provision limiting or regulating a CPC has been upheld,” she said, adding that for years, “we haven’t seen too much success from the legislative route of the state”.
A Supreme Court roadblock
More than 2,500 crisis pregnancy centers operate in the country, outnumbering abortion clinics by nearly 3 to 1 by some estimates. Critics, as well as supporters, said the number of women seeking help from them has grown rapidly in the 11 months since the federal abortion law was overturned, leading to the closure of abortion clinics in dozens of ‘states.
In their absence, CPCs have continued to proliferate. While some provide free services and advice to women with unplanned pregnancies, many have been found to provide women with misinformation intended to convince them to continue with their pregnancies. For example, when two NBC News producers visited state-funded CPCs in Texas last year to seek counseling, they were told that abortions cause mental illness and that implied abortions can also cause cancer. and infertility.
Such experiences are not uncommon: nonpartisan medical experts have long documented how these centers disseminate “misleading or false” information intended to discourage or prevent women from seeking abortion care.
Democratic lawmakers have tried for years to regulate CPCs — many of which are faith-based and receive funding from religious groups, though many also receive taxpayer money — but have run into major hurdles that have prevented them from doing so. enforce such legislation.
These struggles stem from a 2018 Supreme Court case that effectively nullified what had at the time been the most comprehensive state effort to regulate CPCs.
Enacted by California Democrats, this law, called the Reproductive FACT Act, had required unlicensed CPCs to disclose that they were not licensed medical facilities and that those licensed that did not provide a full range of reproductive health care disclose that the state provided free or low-cost care related to prenatal services, including abortion care. The policy, which proponents at the time billed as a “truth in advertising” law, had been built legally around targeting deceptive advertising practices.
But in a 5-4 majority decision in the case, the conservative justices sided with claims by these centers, which are often affiliated with religious or faith-based institutions, that the law likely violated their rights in the first place. amendment because it required them to make statements that they said contradicted their beliefs.
The decision largely silenced any significant state legislation designed to regulate these centers, until 2021, when Connecticut Democrats enacted a narrower law that banned misleading advertising by CPCs, banning them – on their websites and in other marketing materials – of any effort that made them appear. such as abortion services or comprehensive reproductive health care providers.
But after a CPC sued the law last year, the Democratic state attorney general revealed in January that his office had taken no action against such centers in the state, prompting the center to drop his business and let it be known that he would continue to operate.
These two cases have essentially killed any new enactments — even in blue states — of meaningful state legislation targeting CPCs, advocates said.
“At this point, the majority of these kinds of hard-hitting bills – which sought to limit CPC misinformation or require disclosure of services provided – have been monitored by the courts in a way that has had quite a chilling effect. on other states,” Wells said.
A new hyper-targeted approach
Hampered by the broader legal landscape, Democratic state lawmakers introduced or advanced at least 26 bills during their 2023 legislative sessions that seek to regulate CPCs in a much more targeted way, according to an NBC News review of state law related to the subject.
In Colorado, a law signed into law last month regulates the administration of so-called abortion reversal pills – a cocktail of hormones that some CPCs have distributed, under the false claim that they can reverse a medical abortion s they are taken at the right time.
The American College of Obstetricians and Gynecologists has called these pills “not backed by science.”
Colorado law classifies as “unprofessional conduct” any instance of a CPC employee – there are 51 in the state – administering such drugs and subjects them to subsequent “discipline” recommended by the boards of attorneys. ‘State of relevant professional conduct, which typically includes licensure sanctions or suspensions.
The law also considers it a “deceptive marketing practice” for CPCs to present themselves as places of delivery of abortion care or emergency contraception.
In Minnesota, which provides nearly $3 million a year in funding to 90 centers across the state, Democrats have advanced legislation in both legislative chambers that would make that public funding conditional on those centers using only information. medically accurate.
And Democrats in New Jersey and Arizona have introduced bills that would require ultrasounds performed in CPCs to be performed only by licensed physicians.
Such bills are “means of ensuring CPCs are held to higher standards…without necessarily targeting them with an element of consumer protection.” [of legislation]which matches what was closed by the Supreme Court,” said Ashley Underwood, director of Equity Forward, a national group that conducts research on CPCs.
Lawmakers wary of legal challenges of the kind brought against Connecticut and California laws have also — in New Jersey, California, and other states — issued consumer alerts that serve to raise awareness. the public to many of the practices in question employed by CPCs. Such alerts prompt consumers to file complaints with certain state officials — in New Jersey, it’s the state’s Division of Consumer Affairs — but offer no immediate or punitive enforcement action.
Abortion opponents, for their part, continue to defend the centers, saying they have been unfairly targeted by Democrats in blue states.
“Pregnancy Resource Centers exist to help women in need by providing free pregnancy tests, ultrasounds, medical exams, counselling, parenting classes, finance classes; items such as food, diapers and clothing; and financial assistance for housing and utilities,” Kelsey Pritchard, state affairs director for the anti-abortion group Susan B. Anthony Pro-Life America, said in a statement.
“Twisted attempts to obstruct the ability of pregnancy resource centers to serve women prove that Democrats in California, Illinois, Colorado and Minnesota aren’t pro-choice, they’re pro-abortion” , added Pritchard.
Meanwhile, advocates have acknowledged that even their targeted approaches, if adopted, are certain to face legal challenges – but they maintain it is the right strategy at this time.
“Essentially, anything states do, we accept there’s litigation about it, if they’re targeting CPCs,” Wells said.
But, she added, “it is an evil that we want to talk about and that we want to continue to fight against, and we are not going to turn away from it”.